Healthcare Provider Details

I. General information

NPI: 1881694313
Provider Name (Legal Business Name): WASHINGTON COUNTY COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2005
Last Update Date: 07/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 BIRCH AVE
AKRON CO
80720-1513
US

IV. Provider business mailing address

133 BIRCH AVE
AKRON CO
80720-1513
US

V. Phone/Fax

Practice location:
  • Phone: 970-345-2672
  • Fax: 970-345-2702
Mailing address:
  • Phone: 970-345-2672
  • Fax: 970-345-2702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number StateCO

VIII. Authorized Official

Name: TONY N WELLS
Title or Position: DIRECTOR
Credential: EMP
Phone: 970-345-2672